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Frequently Asked Questions About Insurance

We hope these frequently asked questions help answer all of your insurance-related questions. If you don't find what you're looking for, please feel free to contact us.

Should I Bring My Insurance Card With Me?

Yes, the information on your insurance card is needed for us to file a claim with your insurance company. When you register, we will ask for information about your insurance coverage and ask you to sign a few forms. The registration process goes much faster when you bring your insurance information with you.

Will You Bill My Insurance Company For Me?

Yes, as a courtesy we will bill your insurance. It is your responsibility to provide any requested information to your insurance including accident information and claim forms.

We will bill Workers’ Compensation insurance and third party insurance plans if the patient provides the information once our office verifies your claim is open for billing. If your Workers’ Compensation claim is denied, you are financially responsible for your billing.

Do I Need to Let My Insurance Company Know that I'm Going to Be Seen at Wheaton Franciscan Healthcare?

We strongly advise you to check with your insurance company or your employer about this. Because there are so many types of insurance plans, it is difficult for us to tell you whether or not you need prior approval or notification for your services.

How Do I Know if My Insurance Company will Cover My Visit or Certain Services?

Coverage varies with each insurance company. Generally, we do not know whether medically necessary and appropriate services will be covered by your insurance contract. Please refer to your insurance member handbook, contact your insurance company, or contact your employer with specific questions about your coverage.

How Do I Know if My Insurance Company will Cover Services Provided by All Professionals Involved with My Care, Such as Anesthesiologists, Radiologists and Pathologists?

We encourage you to check with your insurance company or your employer about this. Each professional contracts individually with insurance companies and we do not know if each professional is contracted with your insurance company.

How Do I Verify that My Insurance Company has Processed My Claim?

Contact your insurance company at the number provided on your insurance card. You will need to have available the following information:

insurance card

date of service

facility/physician name

original billed amount

patient name

and claim number if available.

Document the information provided by your insurance. If the information is different from what you are being billed by Wheaton, please contact customer service.

How Will I Know if My Insurance Company has Paid My Bill?

You should receive an explanation of benefits (EOB) from your insurance plan that tells you how your claim was processed. You will receive a bill from Wheaton for any balance due from you. If you do not receive a bill, please contact customer service.

What Do I Do if I Disagree with How Much My Insurance Company has Paid?

If you disagree with the payment amount, contact your insurance company and ask them to review how the claim was processed. If your insurance company finds that an error was made, note the information and the name of the person you talked with.

Request an anticipated date your claim will be reprocessed and whether they need additional information from you. If the insurance company feels the bill was paid correctly and you still disagree, request information on appeal rights. Filing an appeal will not guarantee that the insurance company will pay more on your bill, but the claim will be reviewed for reconsideration.

Important Note

Certain locations that are not part of the main hospital campus provide outpatient services as a department of the hospital. These services are generally covered under hospital outpatient benefits. Your co-payment, co-insurance, or deductible may vary depending on your insurance plan benefit. You may have different deductibles for hospital services and physician office visits. Please discuss your plan coverage and options with your insurance benefit specialist.